Posterior approaches in malleolar fracture: when, why and how

L.Branca Vergano, M. Monesi, G. Vicenti, D. Bizzoca, G. Solarino, B. Moretti

Article ID: 5715
Vol 34, Issue 3S2, 2020
DOI: https://doi.org/10.54517/jbrha5715
Received: 9 July 2020; Accepted: 9 July 2020; Available online: 9 July 2020; Issue release: 9 July 2020

Abstract

The treatment of posterior malleolus fractures has radically changed over the last few years, therefore this study aims to summarize the current evidence on the usefulness of posterior approaches in the management of malleolar fractures. The main elements that suggest the use of a posterior approach to the ankle are the posterior malleolus fragment shape and size, the presence of loose bodies at the fracture site: the possibility to obtain an anatomic fixation of the fracture; the presence of a posterior ankle subluxation; the eventually osteochondral impaction of the tibial plafond and the mechanical stability of the joint. The postero-lateral approach has been widely used to treat these fractures, but the posteromedial approach should be considered in specific cases. The anatomic reduction of these fractures lead to joint stability, with a consequent lesser occurrence of post-traumatic arthritis and better functional outcomes.


Keywords

ankle fractures;posterior approach;bimalleolar fracture;trimalleolar fracture;ankle fracture and dislocation


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